post op problems
I have had my right hand operated on the 25th June and the left on the 23rd July. I'm still having problems with both hands. I agree with our last forum conversation that the pain I am experiencing across both palms is pillar pain. Both incisions are still red.
I am still experiencing that during the day, both hands begin to feel like they are swollen up and become clumsy. The hands did the same prior to surgery. Is this normal post op?
During some nights I am waking up again with pins and needles in either hand (which now also includes my small finger). The pins and needles are not as painful as they were prior to the operations.
I had a follow up appointment recently for the previous operations, and they commented that probably my ulnar nerve is causing the pins and needles in my small finger. I also mentioned the pain in my hands but they said it will take many weeks to stop. I have now been discharged with no further investigations or treatment.
I feel at a loss, as both my hands are still in a mess and I can not see them getting any better.
If I am able to get my GP to send a referral to you, would be happy to accept the referral? I note from other forum questions that you have a clinic at the Kings College Hospital in London.
Thank you for your time and effort in your reply. It is much appreciated.
I will go back to my GP and see if he can offer anything. I have never had any nerve conduction studies or imaging. I have only had one steriod injection (by my GP) in my right hand, when it was so swollen, and that worked for a very short time (about two weeks). I think I am just desperate for an end to my annoying hands.
The lack of any pre-operative nerve conduction studies is a pretty serious handicap in trying to analyse the problem now I'm afraid - though it is sometimes possible to get some useful information from the ultrasound imaging even so. JB
My policy on referrals generated from the website is set out on the 'about Carpal-Tunnel.net' page. Essentially I do not really want the site to act as advertising for my clinic and I want to keep my practice and opinions as free of financial bias as possible. For new presentations with CTS I pretty much restrict myself to the natural catchment areas of the two hospitals at which I work and I do not generally accept referrals from outside that area. However for difficult cases there are occasional examples of doctors from outside my normal catchment area wishing to send NHS patients to me for a second opinion and these I accept subject to the approval of the administrators handling the contracting within the NHS 'market' - essentially if a GP in Lincoln sends a patient to me in London someone is going to get a bill from King's College Hospital - it's nothing to do with my income just the way the NHS works (or doesn't) at the moment and if the person getting the bill is not expecting it then it causes grief at both Kings and the referring end. I will not take private referrals from 'outside' when they have essentially been generated by carpal-tunnel.net. There is a bit of a grey area here in that, if I just get a letter from a GP in Lancashire about a private CTS patient there is no way to know for sure what has triggered it but the question has not arisen yet and hopefully will not if people read my policy and respect it.
'Difficult cases' need to be aware that I have no magic wand to cure CTS related problems and, by definition, if you are a difficult case then the chance that I will be able to suggest any dramatically effective course of action is slim. Many of the cases I see with problems after surgery have no obvious treatment options and all I can offer is the rather unhelpful comment that I would probably not have treated it that way to begin with, and the vague hope that things will improve with time. I saw two patients today with problems after surgery and in neither of them do I think there is anything active that can be done to improve the situation. Often I think my major role is simply to discourage further ill-advised surgery.
If that has not put you off then by all means discuss a referral with your GP (or surgeon - but I think they have discharged you now). They can read this forum too of course if they wish. For me to have the best chance of figuring out what the problem is I then need all the previous details - results of nerve conduction studies and imaging, dates of any treatment, especially surgery and steroid injections (with steroid and dose). Gathering all this together can be a challenge in itself.
As regards the current symptoms the little finger could well be the ulnar nerve. Exactly what you can expect in terms of CTS symptoms at this stage depends to some extent on what your nerve conduction studies looked like before surgery. JB